Office visit, established patient (30-39 min)
Facility: Stafford County Hospital
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $127
- Cash Discount Price: $130
- vs. Medicare Baseline: 0.94x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $135.6 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Health Partners-All Plans | $119 - $128 | 88% |
| Humana | $125 - $135 | 92% |
| UnitedHealthcare | $125 - $135 | 92% |
| Va Ccn-All Plans | $125 - $135 | 92% |
| Medica Mcr- All Plans | $125 - $135 | 92% |
Consumer Guidance & Cost Commentary
For this office visit at Stafford County Hospital in KS, the cash price of $130.00 is identical to the facility's median negotiated rate of $127.00 and the state average of $127.00. While the gross charge listed is $130.00, patients with high-deductible plans may find paying cash directly more cost-effective than using insurance, as the insurer's negotiated rate of $127.00 is only slightly lower than the cash price. It is important to note that while the facility is a Critical Access Hospital with government ownership, the cash rate remains competitive against the local market.
To ensure you are not overcharged, always request a prompt-pay discount before scheduling, which can reduce the final bill by 20% to 50% if paid upfront. If you do use insurance, remember that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, and you should never sign away your rights to dispute surprise bills. Finally, if you receive a summary bill, demand a full itemized audit to verify that all charges are accurate and that no services were unbundled or rendered incorrectly.